Provider Demographics
NPI:1326365420
Name:KNAPP, ASHLEY (OT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:KNAPP
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2800 KINMUNDY RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62858-2905
Mailing Address - Country:US
Mailing Address - Phone:618-665-4857
Mailing Address - Fax:
Practice Address - Street 1:2800 KINMUNDY RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:IL
Practice Address - Zip Code:62858-2905
Practice Address - Country:US
Practice Address - Phone:618-665-4857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056008119225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist